Clinical
Our clinical nursing articles aim to inform and educate nurse practitioners and students. This is achieved through the publication of peer-reviewed, evidence-based, relevant and topical articles.
Optimising the conservative management of closed tendinous mallet finger injury
Why you should read this article: • To enhance your knowledge of the different types of mallet finger injury • To explore the different splints available for immobilising a closed tendinous mallet finger injury • To understand the importance of optimal patient education and patient adherence Mallet finger injuries are a common presentation in the emergency department. These injuries result from a forced flexion at the distal interphalangeal joint (DIPJ) that causes extensor tendon disruption, and possibly bone avulsion, at the base of the distal phalanx. This article describes the anatomy, mechanisms, classification and assessment of mallet finger injury. It reviews different types of splints used in the conservative management of closed tendinous mallet finger injury and discusses the latest evidence regarding immobilisation methods and treatment duration. Maintaining the DIPJ in extension during treatment is essential, so the article stresses the importance of patient adherence to treatment.
The provision of emergency healthcare for women who experience intimate partner...
Strategies to address knowledge deficits and negative attitudes
Exploring medicines reconciliation in the emergency assessment unit: staff perceptions...
Why you should read this article: • To recognise why timely medicines reconciliation is important in the emergency assessment unit (EAU) • To understand the barriers to timely medicines reconciliation in the EAU • To identify potential methods of improving medicines reconciliation in the EAU Background Medicines reconciliation is the process of creating and maintaining the most accurate list possible of all medicines a patient is taking. If medicines reconciliation cannot be completed in a timely manner in hospital emergency assessment units (EAUs), delays in treatment can occur, potentially leading to deterioration of long-term and acute conditions, patient distress and complaints. Aim To obtain the perspectives of staff working on an EAU regarding the time patients wait for their medicines to be prescribed, including their awareness of practice and protocols. To determine the time from admission to the EAU until medicines reconciliation, and to identify if there was any time difference in medicines reconciliation according to the day of admission. Method This was a service evaluation in which staff working in one EAU in a teaching hospital in the north east of England were asked to complete a survey in December 2017. The staff survey aimed to ascertain: whether staff were aware of any guidance relating to medicines reconciliation times; how long they thought the average waiting time was for medicines reconciliation; and if they thought there were implications for patients or staff as a result of time spent waiting for medicines reconciliation. In addition, an audit was performed analysing medicines reconciliation times for all patients admitted to the EAU during the month of December 2017. Results A total of 30 staff members responded to the survey. While 40% (n=12) of respondents believed that the EAU had an efficient system in place for timely medicines reconciliation, 90% (n=27) believed the unit could still improve. Almost half the respondents (47%, n=14) perceived a delay in medicines reconciliation could result in exacerbation of patients’ physical conditions. The clinical audit identified considerable variation in medicines reconciliation times, ranging from seven minutes to almost 24 hours. However, most medicines (82%) were reconciled within six hours. Conclusion This service evaluation found that the median time after arrival in the EAU until completion of medicines reconciliation was two hours 48 minutes. However, almost one fifth of patients had to wait for more than six hours, and in one instance almost 24 hours. One potential solution could be increasing the involvement of hospital pharmacists or pharmacy technicians in medicines reconciliation.
Managing the needs of frequent attenders of urgent care services
A case management approach of a new frequent service user manager service
Barriers to effective nurse-patient communication in the emergency department
Identifying what emergency nurses perceive as barriers to nurse-patient communication
Charcot’s foot: a clinical update for emergency nurses
Emergency nurses in the UK have an important role in recognising patients with this condition
Rhabdomyolysis: a case-based critical reflection on its causes and diagnosis
Rhabdomyolysis is a complex condition that can have traumatic and non-traumatic causes
Trauma-informed care for people presenting to the ED with mental health issues
EDs can be challenging environments for people experiencing mental health issues
Assessment and treatment of cutaneous leishmaniasis in the emergency department
Healthcare staff have a vital role in the assessment and treatment of cutaneous leishmaniasis
Exploring the common prescribing errors that occur in the emergency department
Identifying common prescribing errors in one large inner-city ED in South Wales
Using problem-based learning to improve patient safety in the emergency department
Two elements are vital to patient safety in emergency care – work culture and staff training
Recognition and management of autonomic dysreflexia in patients with spinal cord injury
It is important that ENs are aware of the symptoms and management of autonomic dysreflexia